1. Opening of WHO office in Kazakhstan
2. Ratification of the Convention on the rights of disabled people
3. Optimization and automation of the State services in the social and labor sphere
4. Improvement of pension provision system
5. Conference on information and communication technologies in a social security
6. Best Social Projects exhibition
7. Issues of social protection of the population
8. Introduction of mandatory social medical insurance
9. New Labor Code
10. Issues of migration and employment of the population
11. Issues of the disabled people’s rights protection
12. The project of the State program of RK health care development "Densaulyk” for 2016-2019 is developed
13. Development of the Kazakhstan national drug formulary
14. Improvement of mechanisms of the Road Map of Employment 2020 program
11 February, Almaty hosted the opening ceremony of the world's first office of the World Health Organization (hereinafter - WHO) on primary health care (hereinafter - PHC).
The event was attended by the Regional Director of WHO European bureau Mrs. Jujanna Jakab, the First Vice-Minister of Health and Social Development of RK Mrs.Salidat Kairbekova, WHO Permanent Representative in RK Melita Vuinovich and others.
August 4, the Head of the State signed the RK Law "On amendments and additions to some legislative acts of the Republic of Kazakhstan on the issues of pension schemes" directed on improvement of pension provision system.
The law provides:
1. Change of an order of appointing the basic pension payments.
Since July 1, 2017 the basic pension will be assigned depending on an length of participation in pension system only upon reaching the retirement age (58-63/63).
Thus the experience of participation will include the experience developed in PAYG system (the seniority for January 1, 1998), as well as the periods for which mandatory pension contributions (the actual length of pension contributions payment) were paid.
If the seniority of citizen is less than 10 years or is absent at all, the size of basic pension will be equal to 50% of the size of minimum subsistence level (hereinafter - SL).
For each fulfilled year over 10 years the size of basic pension will increase by 2%, and at a 35-year experience and more will make 100% of SL (at an experience of 20 years the size of basic pension will make 70% of SL, 30 years – 90% of SL).
These changes on the one hand will allow to restore social justice concerning those pensioners who for the reasons of absence of data on the income, having the big seniority, receive the low size of pensions, on the other hand - to stimulate today's and future generation of employees to formalization of labor relations.
Change of the mechanism of basic pension on the basis of the documents available in pension file will be made for realization of this norm since 01.07.2017 for actualized pensioners.
2. Introduction of a new conditional and accumulative components of pension system due to establishment of additional 5% of mandatory pension contributions of the employer (hereinafter - MPCE).
Participants of conditional and accumulative components are employees for whom the employer at the expense of own means will transfer mandatory 5% of pension contributions.
These contributions are not property of citizens and will be fixed on the conditional pension account of each worker opened in the Unified Pension Savings Fund.
The right for pension payments at the expense of MPCE will have persons who have reached a retirement age (58-63/63), for whom is opened conditional pension account, subject to MPCE transfer not less than for 60 months, as well as disabled people of I and II groups whose disability is established termless.
The pension is paid for life by monthly payments and not inherited. Annually the sizes of pensions will be indexed depending on financial opportunities of UPSF and demographic indicators.
3. Improvement of pension provision of certain categories of citizens.
Today the main problem in pension provision of staff of force structures are distinctions in sizes of the pensions who reached retirement for long service benefit in different years under equal conditions.
Since January 1, 2016 pension provision of staff of force structures will be transferred to full state provision of pensions.
The size of their pension will pay off depending on a length of service and the remuneration at the time of dismissal from service.
Thus, since 2016, obligations of the government budget for payment of 20% of mandatory pension contributions of remuneration of staff of force structures will be cancelled.
Besides, in the income of the budget will be transferred 50% of the amounts of mandatory pension contributions transferred at the expense of budgetary funds till January 1, 2016 in their favor.
Also for elimination of disproportions in an amount of pension payments of pensioners of the force structures discharged during the different periods of time under equal conditions of service, in 2016 will be carried out single recalculation of the amount of earlier appointed pension payments in incomplete volume taking into account finishing them to the full size, having accepted length of service, the seniority, the remuneration on the date of dismissal according to the materials of the pension files.
These measures will ensure compliance with the international standards of pension provision of military and to raise social guarantees of the military personnel.
Besides, improvement of parameters of pension savings system, expansion of coverage of the population by pension savings system is provided.
As a result of the offered transformations pension payments of citizens will consist of the following parts:
1) the basic pension payment applying depending on an experience of participation in pension system;
2) pension payment from the Center to the persons having the seniority not less than 6 months for January 1, 1998;
3) pension payments from ENPF for the account:
- individual 10% of mandatory pension contributions of the worker;
- additional 5% of mandatory pension contributions of the employer;
- 5% of mandatory professional pension contributions (engaged in hazardous (extremely hazardous) working conditions) (since 2023);
4) voluntary pension savings.
In general, proposed measures will provide and thereafter maintain replacement rates at the level recommended by the International Labour Organization (not less than 40% of salary).
From September 2 till September 5 in Astana hosted the 14th ISSA International Conference on information and communication technologies in social security, on the theme "Towards standards and ICT solutions for social security purposes”.
The event was organized by the International Social Security Association (hereinafter – ISSA) in cooperation with Ministry of Health and Social Development of RK and the State Social Insurance Fund of RK.
The Conference was attended by Mrs.Gulshar Abdykalikova, the RK State secretary, Mr. Errol Frank Stuve, ISSA President, Mr.Hans-Horst Konkolevski, ISSA Secretary General, Mrs.Tamara Duysenova, Minister of Health and Social Development of RK, Mr. Saken Sarsenov, the Vice-minister of Investments and Development of RK, Mr.Alexey Sluchinsky, the Senior Economist of the World Bank, Mr.Ali Tsisse, the Chief Technical Consultant on issues of labor migration of the International Labour Organization, as well as deputies of Parliament, representatives of government bodies and organizations of RK, heads and the senior personnel of ISSA member organizations, heads of divisions on information technologies, managers and ICT experts, as well as representatives from the international organizations and experts of ICT industry took part in conference.
During three-day conference, the social security organization from different regions of the world shared the achievements. Participants of an event analyzed experience and practice in the ICT sphere in a social security of some countries, including Kazakhstan. Particular attention was paid to discussion of common standards and ICT-based solutions to social security.
The Conference also considered new provisions of the ISSA Guide on ICT in the field of management and an exchange of the bases for data of a social security.
"Information and Communication Technologies in the Social Sphere of Kazakhstan" exhibition was organized within the framework of the Conference. During an exhibition the republic's first Kinect - a contactless touch video wall which allows the user to interact with technology through the movements and poses of a body was presented. On the screen are illustrated 6 vital stages of the person which are traditionally designated in the Kazakh culture according to division on мушел жас (mushel zhas) (Sabi, Bala, Zhigit, Azamat, Аga, Aksakal) and how each of them is followed by systems of "e-government". Each of the periods is followed by the package of services (for example, for Sabi period it is a registration of the child birth, receiving benefits and so forth).
October 23 in Astana took place the "Best Social Projects in Kazakhstan" exhibition within which were awarded winners of the republican competition of the same name.
Mrs. Dariga Nazarbayeva, RK Deputy Prime Minister, Mrs. Tamara Duysenova, the RK Minister of Health and Social Development, deputies of RK Parliament, representatives of government bodies and public associations took part in the event organized by MHSD RK and State Social Insurance Fund JSC with assistance of National Welfare Fund Samruk-Kazyna JSC.
Support of the social projects aimed at improvement of life of disabled people, elderly people and other representatives of separate social groups - in a priority of MHSD RK activity.
Thanks to social projects implementation supported and assisted more than 200 thousand citizens in a difficult life situation. Among them are dominated people with disabilities who did not fall into despair having in a difficult life situation. Counter to an illness, courageously and steadfastly they not only fully realize themselves, but also help others solve their problems and find their place in the broad field of activity.
This year, the regional commissions were examined 124 applications; the winners of the qualifying rounds of the competition were 26 social projects.
Taking into account the results of the voting on the MHSD RK site, selection Committee members comprising representatives of ministries, media, members of RK Parliament, public figures, identified the 3 most innovative project.
Winners receive cash prizes from National Welfare Fund Samruk-Kazyna JSC.
The 1st place was awarded to the author of the project from Astana "Production of technical means of rehabilitation with the Kazakhstan trademark "Zharaysyn!" of Banu Iskakova with cash prize of 2 million tenge. The 2nd place was taken by the "Training-cafe" social project from Almaty, its author Anna Kudiyarova has received a cash prize of 1.5 million. tenge. The 3rd place has received "Creation of maternal hands" project from Pavlodar oblast, the author Gaukhar Omarova was awarded with cash prize of 1 million. tenge.
In addition, according to the results of the online voting, the highest number of votes (5042) got "Uncollected Souls House" project of Zhanna Zhanzhigitova from Pavlodar oblast. The author of the project was awarded by souvenir.
As we have informed, the exhibition "Best Social Projects in Kazakhstan» is carried out since 2013. Over three years for participation in the competition for the title of "The Best Social Project" are submitted 317 applications, 64 social projects are recognized as winners. From total number of winners, 10 social projects are implemented at their own expense, 25 are financed with assistance of sponsors and the raised funds, 28 are implemented within the framework of State social order.
October 29, the Head of the State signed the Law of the Republic of Kazakhstan "On amendments and additions to some legislative acts of the Republic of Kazakhstan on social protection of the population”.
This law has been developed in the framework of the implementation of the 84 step of the Nation Plan - 100 specific measures to implement the five institutional reforms, announced by the Head of the State at an expanded meeting of the Government of the Republic of Kazakhstan dated May 5, 2015.
The law provides:
1. Introduction since January 1, 2018 of a new order of rendering the targeted social assistance (hereinafter - TSA) for families with income below 50% of the minimum subsistence level (today – 40%) for each family member, with a condition of mandatory participation of able-bodied family members in active measures of employment which will be provided to replace the existing:
- Special State benefits (hereinafter - SSB) to families with many children;
- State child allowances of up to 18 years for needy families;
- targeted social assistance provided to low-income households.
TSA in a new format will be classified on 2 types: the unconditional and caused monetary assistance.
Unconditional monetary assistance will be provided to families which have no able-bodied members (e.g. families of disabled people or elderly pensioners), or families which able-bodied members for the objective reasons cannot participate in employment assistance measures (for example, single mother with children of preschool age). For such families mandatory participation in employment measures for receiving a grant is not required.
The caused monetary assistance will be provided to the families with at least one working member, subject to the conclusion of the social contract and the mandatory participation of all able-bodied family members in employment assistance measures.
By signing the social contract, the parties undertake mutual obligations: social services undertake measures for assistance of employment and pay a grant, and able-bodied family members – honestly participate in employment assistance measures.
The person not just provided by monetary assistance, they help him to find a job, send to various courses of retraining and professional development. Thus, stimulated the capacity of the family to exit poverty.
2. Transformation since January 1, 2018 of SSB which provides:
- preservation of special state grants to such categories of citizens as participants and disabled people of the Second World War, elderly person, home front employees , etc. (only 14 categories of citizens);
- join of special state grants for disabled people with the state social benefit on disability. It will allow simplifying procedure of grant registration. Acceptance of these measures will not strike at the rights of disabled people as the amount of the received payments will not decrease (state disability pensions will be increased by the sum of nowadays received);
- transformation of special state grants for mothers having many children awarded by suspension brackets "Altyn alka", "Kumis alka" or received earlier a title of "Mother heroine" of the I and II degrees, awarded by the awards of "Maternal Glory", to a grant for mothers having many children which granting will be regulated by the Law "On Welfare Payments to the Families Having Children".
The law makes changes to the Budget code and 7 laws ("On the state awards of the Republic of Kazakhstan" dated December 12, 1995; "On the welfare social benefits on disability, on the survivor's pension and on age in the Republic of Kazakhstan" dated June 16, 1997; "On special welfare payment in the Republic of Kazakhstan" dated April 5, 1999; "On the state targeted public assistance" dated July 17, 2001; "On employment of the population" dated July 17, 2001; "On welfare payments to the families having children" dated June 28, 2005; "On executive production and the status of legal executives" dated April 2, 2010).
Implementation of the Law will demand additional resources from the republican budget in 2018 in the sum of 11,8 billion tenge.
November 18, the Head of the State signed the RK Law "On Mandatory Social Medical Insurance".
The purpose of introduction of mandatory social medical insurance is creation of the balanced and steady system of providing guarantees and obligations of health care delivery based on collective participation of the State, employers and citizens.
Thus, responsibility and level of participation of everyone in a health care system will be accurately defined.
Introduction of mandatory medical social insurance will raise a role and the competition among medical institutions as purchase of services in delivery of health care in system of OSMS will be carried out on the basis of the principle of equality of the state and private subjects of health care. The created OSMS Fund will buy services of providing the medical help where these services are provided more effectively and at the high level that will naturally increase availability and quality of rendering medical services to the population.
It should be noted that when developing the Law was used the best international practices and a principle of social justice.
According to the Law 2 types of packages of medical services will be provided to citizens:
The first – the basic package represents the volume of medical care guaranteed by the state financed from the republican budget. This package will be available to all citizens of Kazakhstan. It includes: ambulance and sanitary aviation, medical care at socially significant diseases and in case of emergency, immunizations.
For unproductively self-employed persons prior to 2020 it is provided the out-patient and polyclinic help with out-patient provision of medicines at the expense of the republican budget.
The second is the insurance package provided by newly created Fund of medical insurance. It includes: out-patient care, in-patient care (except for socially important diseases), the hospital-replacing care (except for socially important diseases), rehabilitation treatment and medical rehabilitation, palliative care and nursing care, high-tech help.
The right to this package is granted to the citizens, foreigners and stateless persons who are constantly living in the territory of RK, being participants of system of mandatory social medical insurance.
Thus the state will carry out payments for economically inactive population. Employers – for hired employees. The employees and self- self-employed citizens registered with the tax authorities – pro se.
In addition to these packages, citizens, with participation in voluntary insurance, can receive medical services on the basis of the contract signed with private insurance companies.
November 23, the Head of the State signed the new Labor code.
The labor code has been prepared pursuant to the orders of the head of State within the framework of the implementation of the Nation Plan - 100 specific measures to implement the five institutional reforms (a step 83).
The new Labor code suggests defining accurately borders of the state intervention in the sphere of labor relations between the employer and employees, and taking into account ensuring balance of the parties’ interests, to distribute their role and responsibility.
The minimum labor standards of guarantees and compensations to employees will be established by the State and rigidly to be provided control of their execution from employers.
The relations between the employer and employees will increasingly be based on the principles of self-regulation, with the strengthening of the capacity of collective negotiations and agreements entered into between them, in such areas as recruitment, personnel transfer and dismissal of employees, working hours, conditions and wages.
The code simplified procedures of hiring, personnel movement, and dismissal, definition of conditions and compensation of employees for employers. Thus basic labor guarantees and the rights of employees with possibility of their expansion through the signed individual, collective contracts and agreements, as well as instruments of protection of their rights and interests are affirmed.
The role of labor unions in ensuring the rights and interests of employees, including taking into account the opportunities provided in recently adopted law "On Labor Unions" is expanded.
Thus, interest of the parties in the conclusion of collective bargaining and agreements that will promote development of practice of an unionization increases.
This model of regulation of labor relations conforms to standards of OECD.
The main innovations provided by the Code are:
1. Simplification of procedures of the employment contract conditions change, especially in the conditions of the crisis phenomena in economy.
This Novella provides creation of such conditions when instead of reduction of number it is easier to employer to introduce the part-time regime of and a temporary transfer of employees for other work.
For example, for preservation of workplaces, it is offered to establish the term of temporary transfer of employees for the entire period of idle time of the enterprise (instead of one month). Also is provided the right of the employer for the transfer of the employer (in case of idle time of the enterprise) on any available vacancies work on which is not contraindicated for health reasons.
2. The basis of cancellation of the employment contract at the initiative of the employer at "the decrease in output, the performed works and the rendered services which entailed deterioration of an economic condition of the organization" is entered.
On previously existing Labor code of reduction of employees is made on the basis of "reduction of number or the employees’ staff” (subparagraph 2 of point 1 of art. 54 of the existing code). Thus the employee is notified in one month without explanation, and at reduction compensation at a rate of an average salary in one month is paid.
Considering that in present crisis conditions, there is a high probability of application by the employer of measures for reduction of employees, the above basis is allocated separately, but thus cancellation of the employment contract possibly at simultaneous observance of the following conditions:
- closing of structural division (shop, site);
- lack of possibility of the transfer of the employee for other work;
- the written notice of labor union not less than in one month with the indication of the economic reasons which formed the basis for cancellation of the employment contract.
At cancellation of labor relations on this basis compensation at a rate of a two-month salary is paid to employees.
Besides, it is offered to grant to the employer the right to stop the employment contract with the employees who reached the retirement age established by the RK legislation accurately having regulated a termination order. Thus possibility of annual extension of the employment contract with the employee who reached a retirement age and possessing high professional and qualification level taking into account his working capacity is fixed (by analogy with the State and civil servants).
3. It is offered to grant to the employer the right of establishment of a trial period to any categories of employees.
This innovation is caused by that the existing ban for employers on establishment of a trial period for the persons under 18, disabled people, university graduates and TIPO, commenced work for the first time got to work, do not promote employment of the citizens belonging to these categories as employers, as a rule, do not employ them.
4. The integrated approach to the solution of employment issues of persons with physical disabilities is provided.
By the current legislation regulation of labor relations with disabled people is regulated by obligations of the employer for employment of disabled people, equipment of their workplace by the special equipment (taking into account restrictions and violations of health functions), providing additional holiday (not less than 15 days), establishment of the reduced working hours (no more than 36 hours per week), a ban on attraction to overtime works, etc. In practice above-mentioned requirements do not promote fully employment of disabled people.
In turn the Code provides preservation of a ban on involvement of the disabled person to overtime works. There are norms on application of the summarized accounting of working hours and the reduced working hours (no more than 36 hours per week) without changes.
Thus, decrease in a certain load of the employer, with division of responsibility between the state, the employer and labor unions, will promote the solution of an disabled people employment issue.
5. Remuneration of employees in the draft Code provides that an employer independently (by adoption of acts of the employer) or at the initiative of employees representatives (by means of the collective agreement conclusion) resolves an issue of a choice of a form, system and the sizes of a salary of employees .
Thus, it is offered to grant the right to employers and representatives of employees to regulate by labor and collective contracts the amount of compensation payments for work at night, in days off and holidays, as well as in the overtime mode. Thus payment for work over the established norms of time should not be less than in a one-and-a-half size from the main rate.
6. It is offered to strengthen the public control sphere, having entered institute of technical inspectors from among the employees nominated by labor union and to provide their powers within the industrial councils on safety and labor protection created on a parity basis.
To the above councils are planned to assign the following functions: the organization of joint actions of the employer and employees on providing requirements of labor protection, carrying out checks of conditions and labor protection on workplaces, informing employees on their results.
Industrial councils on parity conditions will be leaded by representatives of employees and employer on a rotational basis with frequency of 2 years. Decisions of industrial council will be binding for the employer.
November 24 the Head of the State signed the Law of the Republic of Kazakhstan "On amendments and additions to some legislative acts of the Republic of Kazakhstan on migration and employment of population", directed on implementation of the Nation Plan– 100 specific measures to implement the five institutional reforms regarding creating favorable conditions for involvement of highly qualified foreign specialists, as well as for further improvement of policy in the sphere of migration and employment of the population.
The purpose of the Law is improvement of legal and organizational bases in the field of migration policy and policy in the sphere of employment.
The law is directed on modernization of the social and labor relations for improvement of investment appeal of the country and regulation of migratory processes.
The law provides:
1. In the sphere of attraction of foreign labor (hereinafter - FL):
Introduction of the system measures directed on requirements satisfaction of economy in shots through creation of the free market of highly qualified foreign specialists, liberalization of FL attraction procedure by employers to the foreigners arriving to the country for employment.
First, the ideology of delivery of permissions to employers is completely reconsidered.
Now collecting in the budget of the country will be charged. It will help to increase revenues of the government budget which can be aimed at the social and economic development of the region.
Secondly, the foreign experts arriving to Kazakhstan will have an opportunity to find a job independently on the basis of certificates of qualification compliance within 3 months, on any place of the work by profession entering the list of demanded professions in priority branches of economy.
The foreign expert will receive the certain assessment on ball system including the level of his education, an experience, practical experience and other parameters allowing confirming his qualification.
Thirdly, improvement of procedure of the intra corporate transfer is provided, this type of attraction of foreign labor will be brought into line with accepted international standards, with requirements of the World Trade Organization.
Besides, creation of information and analytical system which will be directed on implementation of the specified innovations is planned. It considerably will simplify an order of FL attraction for employers, having many times accelerated procedure of permitting procedure. If now this procedure takes on average 30-40 days, on the offered order it will take on average up to 5 days.
Change of an order of foreign labor attraction, independent employment and the intra corporate transfer is provided since January 1, 2017.
2. In the sphere of ethnic migration:
In 2013 were adopted amendments to the Law "On Population migration” according to which, the resettlement quota of oralmans has been abolished, and along with it, were cancelled all material payments that does not provide for the creation of an enabling environment for the return of compatriots.
For stimulation of return of ethnic Kazakhs to the historical homeland the bill provides:
- providing the oralman status to ethnic Kazakhs, regardless of the resettlement region. Ethnic Kazakhs unlike foreign citizens can obtain a residence permit by contacting the immigration police, without confirmation of solvency;
- receiving a benefits package by ethnic Kazakhs in case of resettlement in the regions identified by the Government with establishment of oralman reception quota. Thus social support can also get by oralman if he moves from any region of the country to the regions determined by the Government for resettlement. However, in case of leaving from such regions, earlier than in five years, the benefits package will returned to the State;
- simplification of procedures for obtaining nationality up to one year after receiving residence permit by them.
3. In the sphere of internal migration:
The main problem of internal migration is the imbalance of the resettlement of the population in the territory of the Republic, in particular between the South and the North. For its decision it is offered to give support only to displace from the labour-abundant regions in the regions defined by the Government. They will provide social package that covers the reimbursement of transportation costs, the provision of office homes or dorm rooms, provision of micro-credit.
Within development of educational infrastructure it is offered in Higher Education Institutions and colleges in the regions determined by the Government to provide expansion of educational places, to modernize and expand quantity of places in hostels, to introduce special grants for rural youth for training in Higher Education Institutions and colleges of northern regions.
4. In the sphere of the population employment:
Norms on determination of the differentiated size of a quota of workplaces for disabled people in the amount of 2 up to 4% depending on the total number of employees are made.
Thus will be created specially equipped workplaces for employment of disabled people by subsidizing of costs of employers for these purposes at the expense of the republican budget (previously there was no such practice).
In addition, in order to avoid duplication are reconsidered employment bodies functions. Transfer of separate functions of employment bodies to employment centers is provided, including functions on unemployed registration, issuing directions on vocational training, employment, issue of references to the unemployed, as well as the formation and updating of the database of the labor market.
December 3 the Head of the State signed the RK Law "On amendments and additions to some legislative acts of the Republic of Kazakhstan on protection of the disabled people’s rights".
For improvement of system of social protection of disabled people, increase of efficiency of services rendering in the sphere of rehabilitation of disabled people, acceptances of appropriate measures for ensuring access of disabled people to work, a physical environment, including transportation, information and communications, taking into account their specific needs to facilities and services opened and provided to all population, the Law amends 24 acts, including 3 codes.
The law provides:
1. Ensuring availability of social, transport infrastructure:
- creation of the barrier-free environment at stations and at the airports;
- equipment of trains by the cars available to disabled people;
- training of transport workers communication skills and providing services to disabled people, including training in sign language;
- allocation at the airports, stations, sites of the welfare sphere, as well as on squares, avenues, streets, blocks free parking places for special vehicles of disabled people which should not occupy other vehicles, etc.
2. Improvement of services in the social sphere (health care, education and social protection):
- ensuring availability of medical care and medical rehabilitation of disabled people;
- improvement of medical and social examination;
- inclusion in a duty of subjects of health care of work on prevention;
- increase in services of experts of sign language for people with hearing impairments;
- development of educational standards taking into account inclusive education;
- ensuring access of disabled children to inclusive education;
- implementation of teaching and educational process at all levels of an education system with respect for the rights of disabled people, etc.
3. Availability of information and housing:
- creation of access of disabled people to necessary information in places of services rendering, as well as on TV and radio broadcasting;
- provision of public services in an accessible form;
- training of the state services workers to communication skills with disabled people;
- provision of housing not above the second floor of disabled people with musculoskeletal disorders;
- inclusion of the third group disabled people in the list of persons who cannot be moved from the official dwelling without granting other dwelling, suitable for accommodation;
- preservation of the right for housing in case of temporary residence of the disabled person in medico-social establishment.
4. Improvement of legal aid:
- granting a draft exemption for the single male child in a family with disabled person;
- providing disabled people with means of rehabilitation during enduring the punishment;
- carrying out legal consultation by the lawyer in a place of stay of the disabled person, etc.
According to the National Plan of the President of the Republic of Kazakhstan N. Nazarbayev is developed "100 specific measures to implement the five institutional reforms" the project of the State program of RK health care development "Densaulyk" for 2016-2019.
The main goal of the Program determined strengthening of health of the population for ensuring sustainable social and economic development of the country.
As a result of implementation of the Program by 2020 the remaining life expectancy of the population of the Republic of Kazakhstan will increase up to 73 years.
Within the framework of Program on the basis of further development of health care will be put creation of the public health care system (PHCS), on the basis of integration of epidemiological service and service of a healthy lifestyle formation and rationalization of nutrition.
The PHCS main functions will become:
- public awareness and involvement in activities to prevent and reduce the harmful effects of various environmental factors, unhealthy eating habits and behavioural risks;
- provision of epidemiological monitoring for communicable and major non-communicable diseases, including mental health problems and traumatism;
- providing, coordination and expansion of the cross-sectoral synergies directed on protection and strengthening of health of the population;
- ensuring control of compliance with the law and other precepts of law in the field of health protection and epidemiological safety;
- introduction of the international systems of long-term modeling and forecasting of development of diseases at the regional and national levels.
PHC will become the central link in system of medical care. Thus medical aid within PHC will be considerably expanded with stage-by-stage increase in the list of medicines for free out-patient treatment. Actually, PHC has to become the universal, integrated, socially oriented, available and high-quality medical care on primary link.
Universality of primary health care will be provided by further transition to the family principle of service. Family-based services will include monitoring of health of the person throughout his life, taking into account the characteristics of the organism at each age period, with the emphasis on prevention.
Family-based principle assumes carrying out preventive, diagnostic, medical, rehabilitation and improving and, palliative care and home-based care, proceeding from needs of each family according to the individual card of supervision and improvement of a family.
Family-based services will be carried out by general practitioners (GP) and/or multi-disciplinary teams from among current district doctors (therapists, pediatricians, gynecologists), depending on personnel equipment of the particular region. In process of growth of being equipped by general practitioners and their competences, they will replace multi-disciplinary teams.
Priority of PHC work will be a strengthening of health of mother and child. PHC will become a basic level of programs of regionalization of medical care at various diseases, including the perinatal help. PHC experts will coordinate delivery of health care at all levels of a health care system, including diagnostics and profile experts services, direction to a hospital, rehabilitation, palliative care and home-based care (routing). They will monitor completeness and quality of rendering of services at all stages of medical care.
Also further development of transport medicine, including air medical service, an emergency medical service and telemedicine, network of mobile pharmaceutical units will be carried out.
Further development will receive specialized medical care (SMC) with integration of all health services. Thus, taking into account current state of health of the population and the predicted growth of non-communicable diseases is provided development and stage-by-stage introduction of the integrated model of the medical care organization.
This model will cover the main socially important, noncommunicable diseases and diseases significantly influencing a demography of the population:
- acute myocardial infarction;
- acute cerebrovascular accident (stroke);
- malignant neoplasms;
- pregnancy and childbirth.
On each block on the basis of the clinical guidelines and protocols recommended by the international professional organizations will be developed and started action plans. It will allow providing all service: prevention, medical actions, including rehabilitation, dispensary supervision, medical and social services.
Along with it, development of highly skilled special medical care with attraction of the best world practices will proceed.
Along with improvement of quality of rendering medical services to the population, the Program is set the task of rational use of resources of health care. This primarily concerns funding.
For example, the share of expenses on health care in % of GDP makes in Turkey - 6,7, South Korea – 7,2, Norway – 9,1, the USA - 17,9, and on average over the OECD countries– 8, and in Kazakhstan only 3,8%.
The modern medicine with development of new technologies becomes resource-intensive. And this increase will be directed, first of all, on improvement of quality of medical services. In this regard the draft of the Program included specific measures for rational use of medicines, medical equipment, and improvement of staffing and management of the medical organizations.
Effective management of the specified resources will be reached by introduction of the progressive forms of corporate management by the medical organizations providing balance of interests of the parties. In development of infrastructure of system will be more widely used PPP mechanisms for attraction of investments into branch. In issues of providing medical equipment transition to the leasing mechanism of purchase directly at producers, with an option of the repurchase and field service is planned.
To address the issues of quality, safety and affordability of medicines, provided to the population in 2015 experts of MHSD RK together with experts of the World bank, Europe and Australia have developed the Kazakhstan national drug formulary (hereinafter - KNF). The British national drug formulary which is considered in the world as "the gold standard" is taken as a basis of KNF and is the model formulary of World Health Organization.
KNF will allow to expand the competitive environment and to increase transparency at purchase, as well as will give option to choose preparations based on patient-oriented model of medicines provision. Thus, it will become the big reference book, both for doctors, and for citizens of the country. Besides, it will give the chance of each medical organization to create the drug formulary, correctly plan the budget depending on a profile and the price of a preparation.
In 2015 experts of MHSD RK in pursuance of an order of the Head of State on prevention of growth of unemployment carried out works on updating of the Road Map of Employment 2020 program. On December 8 of this year the RK Government approved the changes in "RME 2020" directed on preservation and creation of workplaces.
For preservation of workplaces of skilled employees of the industrial enterprises is provided introduction of the mechanism of temporary subsidizing of 2/3 salary, lost due to reduced working time.
Also is provided the organization of training of employees, including the working youth, with joint financing from the employer or completely at the expense of the state, subject the enterprises keep workplaces for them.
For creation of additional workplaces will be strengthened tools which are used in "Road Map of Employment": employment on infrastructure projects; use of potential of the projects implemented within all state, industry and regional programs; microcredit for business development.